August 10, 2012
About 2.8 percent of participants in a major study of black gay and bisexual men in six U.S. cities during 2009-11 became infected with HIV each year. This infection rate was almost 1.5 times that of white men who have sex with men (MSM), said study co-chair Kenneth Mayer of Fenway Community Health in Boston.
Black MSM under age 30 had an incidence of about 5.9 percent per year, "or about three times the rate of white MSM," said Assistant Dean Sheldon D. Fields of Florida International University. "These rates are comparable to [what is seen in] countries in sub-Saharan Africa that are hardest hit by the epidemic."
Black MSM "engage in comparable, if not less risky behavior than other gay men," said CDC researcher Gregorio Millett. Young black MSM "are less likely to have amphetamine use, injection drug use, less likely to use drugs during sex, but they are still five times more likely to be HIV-positive and two-and-a-half times more likely to have an STD," he said. "We need to refocus on the context."
Higher overall prevalence among black MSM, lack of health insurance, and poverty-related lack of medical care for HIV are among such contextual factors. "In terms of viral suppression, we are far less likely, at least 50 percent less likely, to be virally suppressed compared to white gay men," Millett said. So the same level of risky behavior can carry a greater risk of infection for black MSM.
The Affordable Care Act could be "the biggest game-changer" for black MSM, Millett said. Higher rates of testing and linkage to care could help reduce the risk of new infections. One study being developed will look at how pre-exposure prophylaxis (PrEP) can fit with other prevention tools for black MSM, said Fields.